Oncological Pathology Research Articles

Результативность профилактической маммографии в Российской Федерации: сравнение итогов первого этапа диспансеризации в 2019 и 2022 гг.

Globally, malignant neoplasms (MN) of the breast remain the most common type of cancer pathology in the female population. The main method of prevention of this pathology is screening digital mammography (MMG). In the Russian Federation, its effectiveness was evaluated in the period 2013–2019. It seems relevant to study the development of the situation in recent years, taking into account the COVID‑19 pandemic. Purpose of the study is to examine comparatively the volume, dynamics and effectiveness of preventive mammography studies in the context of the impact of the pandemic and the rationale for the further development of medical prevention. Materials and methods. Comparative study of the volume and effectiveness of preventive MMG. Consolidated reports based on the accounting form of medical documentation N131/u «Record card of preventive medical examination (screening) » for the period from 2019 to 2022 were analyzed. Analytical methods and descriptive statistics methods were used. Results. In the Russian Federation, the number of preventive MMGs in 2022 increased by 4.7%, compared to 2019. Administrative-territorial units also predominantly saw an increase in the number of MMGs, except for the city of Moscow, the Central and Siberian Federal Districts. The most significant increase was in the North Caucasian (38.0%) and Southern Federal Districts (22.2%). The pathologic incidence of breast MN according to the results of prophylactic mammography in 2022 increased significantly, by 26.4% in the Russian Federation as a whole. The exception was the city of Moscow, where a decrease in the indicator by 11.8% was noted. Various pathologic conditions during MMG are detected on average in 6.9% of cases, breast MN – in 1.0% of cases, first-time oncologic pathology is detected in 0.25% of cases. Findings. For further development of medical prevention of breast MN it is necessary to create and implement new organizational technologies, including tools for automated analysis of the results of preventive mammography.

Bibliometric analysis of scientific literature on the use of suppositories in the treatment of prostate cancer patients

Nowadays, cancer remains one of the main causes of death worldwide. Statistical data from various literary sources indicate that more than 130,000 people in Ukraine receive this diagnosis as a sentence every year. Cancer can affect any organs of the human body and, over time, the entire organism. In 2024, the agency of the World Health Organization on cancer and the International Agency of Cancer Research published the latest statistical estimates of this pathology in a global format, where prostate cancer is among the five most common oncological pathologies and takes the fourth place. Oncological diseases are one of the priority areas of healthcare development in accordance with the Order of the Ministry of Health of Ukraine No. 1832 dated 07.10.2022 “On Approval of Priority Areas of Healthcare Development for 2023–2025”. It was this fact that determined the choice of the direction of this research in the matter of finding information on the provision of pharmaceutical care, namely the use of a drug – a rectal suppository for the treatment of prostate cancer. The aim of the work is to carry out a bibliometric analysis and further generalize the data of the scientific literature to study the prognostic value and features of the prescription of suppositories in the treatment of prostate cancer. Materials and methods. The data search was conducted in the PubMed electronic database using the following key terms: “prostate cancer and suppositories”, “prostate cancer”. To monitor and analyze international scientific research, with the help of visualization tools and modern SciVal citation metrics using the online platform, bibliometric analysis can be performed. Using the VOSviewer functional program, bibliometric networks were constructed and visualized. Results. A map of the relationships between the most used keywords on the topics of “prostate cancer” and “prostate cancer and suppositories”, grouped into clusters for the period from 1986 to 2024, was built. The clustering of the most used keywords on the subject of “prostate cancer” for the specified period is summarized. According to the bibliographic analysis, interest in the above topic was highest in 2014 and 2021. Conclusions. According to the bibliographic analysis, the interest in the subject of the patients’ treatment with prostate cancer disease continues to grow from 1998 up to the present. The analysis of publication activity using the visualization tool of bibliometric networks VOSviewer for the period from 2014 to 2024 for the key words “prostate cancer” has shown the presence of 14 clusters. The largest cluster is devoted to modern methods of prostate cancer treatment, studies of gene rearrangement, target therapy, carcinogenesis.

USING ARTIFICIAL INTELLIGENCE FOR BIOMARKER ANALYSIS IN CLINICAL DIAGNOSTICS

Introduction. Artificial intelligence (AI) technologies are becoming crucial in clinical diagnostics due to their ability to process and interpret large volumes of data. The implementation of AI for biomarker analysis opens new opportunities in personalized medicine, offering more accurate and individualized approaches to disease diagnosis and treatment. The relevance of this review stems from the need to systematize recent advances in AI application for biomarker analysis, which is critical for early diagnosis and prediction of chronic non-communicable diseases (NCDs). Material and methods. The analysis of peer-reviewed scientific publications and reports from leading research centers over the past five years was conducted. Studies on the application of AI algorithms for analyzing genomic, proteomic, and metabolomic biomarkers were reviewed, including machine learning methods and deep neural networks. Special attention was paid to the integration of multi-marker panels for improving the accuracy of diagnosis and prediction of cardiovascular, digestive, respiratory, endocrine system diseases, as well as oncological and neurodegenerative pathologies. Results. The application of AI has significantly increased the sensitivity and specificity of diagnostics, especially in complex cases requiring analysis of multiple disease parameters. The effectiveness of AI has been demonstrated in early diagnosis of lung, breast, and colorectal cancer, prediction of cardiovascular complications and NCDs progression, including diabetes mellitus and Alzheimer’s disease. AI’s significant contribution to the discovery of new biomarkers, optimization of personalized treatment, and improvement of therapeutic strategies has been noted. Conclusion. The use of AI in biomarker analysis has become a significant breakthrough in medical diagnostics, particularly in oncology, cardiology, and neurodegenerative diseases. The technology allows integration of data about various biomarkers and contributes to creating more accurate models for disease diagnosis and prediction. Further development is associated with technology advancement and overcoming ethical and regulatory barriers, which will expand AI capabilities in clinical practice.

Alterations in store-operated calcium entry in neurodegenerative pathologies: history, facts, perspectives

Neurodegenerative disorders, along with cardiovascular and oncological pathologies, are one of the most actual issues facing modern medicine. Therefore, the study of the molecular mechanisms of their pathogenesis and the search for new drug targets is highly demanded. Neuronal calcium signalling has attracted close attention, as altered calcium homeostasis has been demonstrated in the pathogenesis of various neurodegenerative diseases. In this review, we focus on one of the most ubiquitous and important pathways for calcium uptake: store-operated calcium entry. Here we describe studies demonstrating disturbances in store-operated calcium entry in various neurodegenerative pathologies, including Alzheimer’s, Parkinson’s and Huntington’s diseases. Also, we analyse the molecular determinants underlying these disturbances and propose ways for pharmacological correction of altered calcium signaling. The information summarized in the review will allow us to consider store-operated calcium channels as promising targets for the drug development in order to treat neurodegenerative pathologies and outline further promising directions for the investigation.

An integrated approach to the preservation of reproductive material in patients with oncological pathology

Background. Every year, the number of patients who face cancer without having time to realize their reproductive function increases. In view of this, there is a growing need to develop and improve various ways to preserve fertility in this category of patients. The most common techniques are in vitro maturation of oocytes and controlled ovarian stimulation followed by vitrification of oocytes and embryos. At the same time, transvaginal puncture (TVP) has a risk of developing complications such as bleeding or an infectious process. Disorders of the vaginal microflora also increase the likelihood of inflammatory diseases. In this regard, the correction of vaginal dysbiosis is an integral part of the protocols of assisted reproductive technologies before the TVP. Aim. Development of an integrated approach to the preservation of reproductive material in patients with oncological pathology. Materials and methods. A prospective randomized study of 39 women with an identified oncological process and bacterial vaginosis was conducted. The patients were divided into 2 groups: oral probiotic was added to clindamycin therapy in group 1, and vaginal probiotic in group 2. The ovarian reserve was examined for everyone, the qualitative composition of the vaginal microflora was determined, pH-metry was performed and related specialists were consulted if necessary. Results. The patients are comparable in age and ovarian reserve. When using an oral probiotic, an improvement in the qualitative composition of the microflora was noted due to a decrease in opportunistic flora (Gardnerella vaginalis) and an increase in the number of lactobacilli. The vaginal probiotic showed comparable results, but the recurrence rate was 28%, while in group 1 it was 18%. It was noted that when taking Enterolactis Duo, the symptoms associated with chemotherapy treatment decrease. During the study, 396 oocytes were obtained, of which 212 are suitable for vitrification and fertilization. Conclusion. Currently, the development of oncofertility methods and their improvement remain one of the urgent problems. Taking an oral probiotic helps to normalize the vaginal microflora, neutralize the risks of infectious complications in TVP, reduce the likelihood of recurrence of dysbiosis and the development of adverse events associated with chemotherapy. The use of ovulation stimulation demonstrates higher rates compared to in vitro maturation. However, a combination of these procedures can be used to increase the amount of material obtained, which is subsequently used in assisted reproductive technology protocols.

CHARACTERISTICS OF THE HOSPITALIZATION PERIOD IN PATIENTS WHO DIED AS A RESULT OF COVID-19 WITH ACUTE CARDIOVASCULAR COMPLICATIONS

The aim. To identify adverse risk factors in hospitalized patients with fatal consequences of the coronavirus disease-2019 and its acute cardiovascular complications. Materials and methods. A retrospective study was conducted of 66 people in the study group with acute respiratory failure and cardiovascular complications due to COVID-19. The comparison group was 48 people who died of acute cardiovascular events without SARS-CoV-2 infection or other bacterial or viral diseases. The criteria for inclusion in the study group were the presence of confirmed SARS-CoV-2 infection by the polymerase chain reaction method, the presence of acute cardiovascular complications during COVID-19, and patients hospitalized during its treatment. Inclusion criteria for the comparison group were hospitalized patients with acute cardiovascular diseases that led to death without SARS-CoV-2 infection. The exclusion criteria for both groups were: age before 18 years old; absence of informed consent of the authorized person of dead person or the decision of the authorized person to withdraw from the study at any of the stages; the presence of other co-infections that could have a cumulative negative effect on the state of the respiratory and cardiovascular systems (flu virus, hepatitis virus, human immunodeficiency virus, pathogens that led to symptoms of acute intestinal infections). Age and gender distribution, comorbidities, length of hospitalization, and laboratory markers were evaluated in both cohorts. Cardiovascular complications were confirmed by the results of ultrasound examinations, computed tomography angiography and comparison with postmortem morphological findings in autopsy reports for the analysis of the current study,. The results. There were 48 men (72.7%) and 18 women (27.3%) in the study group of 66 patients who developed cardiovascular complications at the background of COVID-19, and in the comparison group – 39 men (81.3%) and 9 women (18.7%), which indicates acceptable comparability of the groups among themselves due to sex (p=0.374) and age (p=0.338). In particular, the age median for men in the study group was 65 years (IQR - 21 years), with minimum and maximum age values ​​– 36 and 83 years, respectively; the median age for women in the study group was also 65 years (IQR – 12.5 years), with the lower and upper age limits in the group being 41 and 78 years. The age median for men in the comparison group was 62 years (IQR 15 years), with a lower and upper age range of 54 and 81 years. The age median for women in the comparison group was 68 years (IQR – 16.5 years), with the lower and upper age values ​​in the group being 55 and 79 years. Men and women of the comparison group did not statistically differ from each other in terms of age (р=0.412). A significant difference was found between the length of hospitalization in both cohorts (р˂0.00001) – the median length of stay in hospital for the study group was 15 days, and for the comparison group – 10 days. It was established that malignant diseases were an additional concomitant factor of mortality in the group of patients with COVID-19 (р=0.043). The percentage ratio of neutrophils (p=0.048) and lymphocytes (p=0.031) in patients of the study group significantly differed. Conclusions. Unfavorable risk factors in patients with fatal consequences of Coronavirus disease-2019 and acute cardiovascular complications were concomitant oncological pathology, a long period of hospitalization, and changes in the percentage ratio of neutrophils and lymphocytes.

Role of Tumor Microenvironment in the Risk of Thromboembolic Complications in Ovarian Cancer

Introduction. Incidence of ovarian cancer remains high in the overall prevalence of oncological pathology. Adjuvant chemotherapy refers to its treatment options. Patients with oncological pathology are faced with a high risk of thrombosis and thromboembolism, with up to 30% lethal outcome within a month of its development. A number of cancer cells are known to induce platelet aggregation, contributing to thrombosis and metastasis as a result of this interaction. Accordingly, the paper is aimed at presenting a clinical case for demonstrating the role of P-selectin expression in the complications in a patient with ovarian cancer. Materials and methods. The present paper evaluates platelet activation marker in a patient undergoing chemotherapy courses after cytoreductive surgery. Following the case conference and in accordance with the clinical recommendations of the Russian Oncology Association (AOR) and Russian Society of Clinical Oncology (RUSSCO), cytoreduction (CC-0), radical hysterectomy, transverse colectomy, left hemicolectomy with rectum resection were performed. The interventions included ascendostomy, pelvic, lateral right-sided and left-sided peritonectomy, pelvic lymphoadenectomy, total omentectomy, Renape-French HIPEC (hyperthermic intraperitoneal chemotherapy), abdominal and pelvic drainage. Expression of P-selectin on the platelet surface was measured as a marker of platelet activation. Results and discussion. At the time of admission, the patient had high CD62 expression activity compared to healthy volunteers (CD62 ADP- — 11.2%, CD62 ADP — 24.7% vs CD62 ADP- — 1.3%, CD62 ADP — 17.2%). During the complex treatment of ovarian cancer, the platelet activation increased (CD62 ADP- — 21.8 %, CD62 ADP+ — 30.1 %). At discharge, CD62 expression values reached the conditional norm, presumably indicating thrombosis development. Conclusion. Tumor microenvironment influences the hemostasis system. Detailed study into this issue obtains a high potential for the prevention of primary and secondary thromboembolic complications in oncologic patients.

Efficacy of Doxorubicin in the Adjuvant Treatment of Canine Splenic Visceral Hemangiosarcoma

Introduction. Splenic hemangiosarcoma is a highly malignant neoplasm that affects geriatric patients. The incidence in dogs is 45–50% of all splenic tumours and about 2% of all oncological pathologies. The visceral form of splenic hemangiosarcoma is characterised by the most aggressive course of the disease and early metastasis to other organs. The average life expectancy of animals after splenectomy, according to various scientific data, is from 20 to 90 days. The article studies the efficacy of additional doxorubicin-based adjuvant chemotherapy to increase the life expectancy of dogs at different stages of the disease.Materials and Methods. To compare the life expectancy, the patients were divided into 4 groups receiving different treatments for splenic hemangiosarcoma. Examination of patients, visual diagnostics and pathomorphological diagnostics were used for making a diagnosis, determining the stage of the disease and prescribing treatment. Treatment efficacy was assessed based on the median relapse-free period, median life expectancy and survival rate of patients after 3, 6, and 12 month periods. Statistical analysis was performed using the Fisher's exact test.Results. The obtained data demonstrated a more favourable course of disease in dogs with the stage I tumour process. Splenectomy made it possible to increase the life expectancy of patients to 243 days with a 6–month survival rate in 62.5% of patients. Postoperative chemotherapy treatment combined with doxorubicin significantly improved the longterm prognosis and led to more than twofold increase in life expectancy of dogs (up to 475 days) with a one-year survival rate in 83.3% of patients. However, no substantial statistical significance was determined in the studied groups (p=0.7).Discussion and Conclusion. The results of the research have revealed the efficacy of adjuvant doxorubicin-based chemotherapy in dogs with the visceral forms of splenic hemangiosarcoma. In animals with early stages of the disease, a significant increase in life expectancy has been discovered. The development of hemagdomain and/or the presence of metastasis to abdominal organs indicate the unfavourable course of the disease and, as a consequence, early metastasis. Nevertheless, even at these stages, doxorubicin can increase the life expectancy of patients.

Impact of the COVID-19 Prioritization Recommendations on Pathological Stages of Urologic Malignancies: A Real-World Analysis at a High-Volume Referral Institution

Background: In response to the COVID-19 pandemic, the European Association of Urology (EAU) Guidelines defined priority groups to guide the prioritization of surgery for urological malignancies. The objective of this study was to evaluate the impact of the COVID-19 prioritization recommendations on tumor pathological characteristics in a real-world setting at our academic referral institution. Methods: We compared baseline and pathological tumor features of all patients with urological malignancies treated during the pandemic period (2020–2021) versus in the post-pandemic period (2022–2023). Our institution adhered to the international recommendations and prioritized those cases defined as “high-risk”. Results: Data from 9196 patients treated for urological malignancies were reviewed and grouped according to period of surgery (4401 in the pandemic period vs. 4785 in the post-pandemic period). The overall number of surgical procedures was comparable for all diseases except for the number of radical prostatectomies (1117 vs. 1405; p = 0.03) and partial nephrectomies (609 vs. 759; p = 0.02), which were significantly lower in the pandemic period. Regarding tumor pathological features, none of the recorded variables were found to differ according to period of surgery, including disease stage, tumor grading, presence of necrosis, lymphovascular invasion, and histological variants. Conclusions: A correct policy of prioritization of oncological pathologies during emergency periods and a centralization of oncological cases in reference centers reduce the possible risk of worsening cancer disease features related to the reorganization of healthcare resources.

Costs of Palliative Care in Oncological and Non-Oncological Patients with Different Types of Ambulatory-Based Attention: Cost-Study Protocol.

Background: Ambulatory-based palliative care is vital to managing oncological and non-oncological patients. Its economic impact on the healthcare and social system has recently begun to be considered significant. It is essential to agree on the cost types, the methodology for approaching and analyzing these costs, and how to determine the burden imposed by this attention on the healthcare and social system. Aim: This study aims to design a study on the economic burden of palliative care (PC) in oncological and non-oncological pathologies in the context of outpatient care (ambulatory-based and home support teams). Methods: A prospective cross-sectional study on the economic burden of ambulatory-based palliative care (ABPC) in three phases is conducted. Phase I: A systematic literature review (SLR) first defines the methodology and data to acquire for costing (results already published). Phase II: The next phase is the piloting of the registration questionnaires for costs/expenses (results already analyzed and presented). Phase III: A cross-sectional study is being conducted to collect data on the direct and indirect costs of ABPC assumed by the healthcare system and patients/caregivers to estimate its economic and social burden (in progress). Discussion: In this study, we create and propose a methodology and extend the approach to the funding of PC in an ambulatory-based context to determine its social cost and provide stakeholders with more information to assign resources more efficiently.

Nutrition Rehabilitation in Oncopathology: Opportunities and Prospects

Nutritional corrective support is an integral component of rehabilitation programs in the perioperative period for oncological pathology. The aim of this study was to evaluate the effectiveness of including remaxol in the rehabilitation treatment regimen for gastroenterological cancer patients. Material and methods. The treatment results of 42 patients with gastric outlet tumors and small intestine tumors were retrospectively analyzed. Remaxol was included in the adjuvant therapy for patients in the main (I, N=22) group: intravenously 400 ml at a rate of 40–80 drops/min (2–4 ml/min) once a day for 10 days. Patients in the comparison group (II, N= 20) received traditional nutritional therapy. The study used both traditional clinical diagnostic methods and methods for assessing the risks of nutritional deficiency and the rehabilitation potential of the body, its adaptive capabilities, and disease prognosis. Results. All patients showed signs of severe nutritional deficiency, endotoxemia, intoxication, and hepatotoxicity. Liver detoxification parameters were better in patients who received remaxol as an adjuvant therapy than in the comparison group. Conclusions. Cancer patients with a high nutritional risk and moderate to high nutritional deficiency are at a higher risk of developing toxic complications requiring adjuvant therapy. The inclusion of remaxol in adjuvant therapy reduced the severity of hepatotoxic reactions in these patients. The data obtained made it possible to recommend its inclusion in treatment regimens for patients with this pathology.

Modular Universal Tumor and Revision System Prostheses in Patients with Bone Cancer of the Lower Limbs: A Narrative Review of Functional Outcomes.

The optimal management of bone tumors requires a multidisciplinary strategy to guarantee high-quality care. At specialized centers, the medical team responsible for managing patients with bone cancer comprises oncologists, surgeons, radiologists, pathologists, and rehabilitation specialists. The goal of treatment is to achieve long-term survival with minimal disability and pain. Postoperative rehabilitation is a fundamental therapeutic approach to enhance functionality and sustain the utmost quality of life following a limb-sparing surgery. Currently, megaprostheses are used for reconstructing bone defects after tumor resection, but in the literature, only a few studies have investigated rehabilitation outcomes in terms of functionality and impact on daily activities. This narrative review explores the functional and quality of life outcomes after the implantation of MUTARS® prostheses in patients with lower extremity bone tumors. A comprehensive search was conducted on PubMed and Scopus using the following MESH terms: "MUTARS", "Megaprosthesis", "bone", "tumors", "metastasis", "lower limb", "rehabilitation", "outcome", and "quality of life", and 10 studies were included. The most frequent oncological pathology was found to be primitive bone tumors treated with modular prostheses. The outcome measures used were the Henderson et al. classification, Harris Hip Scale, Musculoskeletal Tumor Society score, Visual Analog Scale, Range Of Motion, Karnofsky Performance Scale, and quality of life questionnaire. MUTARS® is a well-established treatment option after bone tumor resection, although it involves extensive and complex post-resection reconstruction that exposes joints and tissues to substantial mechanical stress. Proper rehabilitation after MUTARS® surgery is a fundamental therapeutic step, although there is still insufficient evidence in the literature focusing on functional and rehabilitative outcomes. Therefore, more studies and guidelines are needed to define standardized rehabilitation protocols for clinical practice after orthopedic oncologic surgery.

КЛИНИЧЕСКАЯ ЭФФЕКТИВНОСТЬ НЕГОРМОНАЛЬНЫХ МЕТОДОВ ТЕРАПИИ ПАТАЛОГИЧЕСКОГО КЛИМАКТЕРИЧЕСКОГО СИНДРОМА У ЖЕНЩИН

The purpose of the study is to study the clinical effectiveness of the dietary supplement "Menophen" in comparison with β-alanine in the treatment of menopausal symptoms in women in the perimenopausal, menopausal and postmenopausal periods. Menopausal syndrome is a complex of vegetative-vascular, psycho-emotional, metabolic-endocrine, vaginal, sexual and other disorders. According to domestic authors, vasomotor disorders such as hot flashes, lability of blood pressure and pulse, increased sweating, chills, which significantly reduce the quality of life of patients and disrupt the circadian sleep-wake rhythm, come to the fore. Today, menopausal women continue to work actively, but hot flashes and sleep disturbances significantly reduce their level of performance and increase the number of absences from sick leave by 82%, compared to women without hot flashes. At the same time, 87.5% of women refuse to use and prescribe MHT, expressing doubts about the safety of their use; the main fears of patients are weight gain and the development of oncological pathology. Treatment with the dietary supplement Menofen leads to a decrease in the number and severity of psycho-emotional, metabolic-endocrine and neurovegetative disorders in menopausal women.

Rationale for antimicrobial activity of phytocomplexes recommended for use in oncological pathology

Rationale for antimicrobial activity of phytocomplexes recommended for use in oncological pathology

Problems of total temporomandibular joint prosthesis in oncologic patients: literature review

The most common cause of total temporomandibular joint (TMJ) prosthesis is the terminal stage of degenerative dystrophic diseases. Patients with oncologic pathology usually undergo extended surgical interventions with TMJ exarticulation which in contrast to non-tumor pathology are characterized by resection of the whole ligamentous apparatus of the joint, the ramus of the mandible, and surrounding structures. Due to various causes, the use of traditional systems of open-type joint prosthesis (without fixation of the joint head in the glenoid fossa) frequently leads to loosening, luxation, and eventual dislocation of the joint head from the glenoid fossa. Currently, multiple different TMJ prosthetic systems have been proposed but only 2 are routinely used: TMJ Concepts (USA) and TMJ Biomet (USA). It should be noted that these systems are also open. We have studied the used constructions of total TMJ endoprostheses and haven’t found any that solve the problem of the condyloid component dislocation from the glenoid fossa after extended resections due to tumors of the TMJ. Moreover, analysis of the clinical outcomes after the use of such systems showed that even in cases of relatively limited resections of TMJ structures (11–30 %), joint prosthesis elements dislocation still occurs. Therefore, a promising solution for the problem of the joint head dislocation can be development of a closed total endoprosthesis with joint head fixation and preservation of joint mobility in all planes.

Abstract C149: Relationship between PD-L1 expression and clinicopathological characteristics in Hispanic/ Latino women with breast cancer

Abstract Background: Programmed death ligand 1 (PD-L1) expression in breast cancer serves as a prognostic marker, particularly in aggressive subtypes like triple-negative breast cancer (TNBC), where it helps in predicting response to immune checkpoint inhibitors and guides immunotherapy use. Although several studies have assessed the prevalence of PD-L1 expression in breast cancer, data from the Hispanic population, especially in Latin American countries, is lacking. This study evaluates PD-L1 expression and its correlation with pathological features in Colombian women. Methods: Women with breast cancer tested for PD-L1 were selected from the archives of the Oncologic Pathology Department at the National Cancer Institute of Colombia from September 2021 to May 2024. Information from their pathology reports was extracted, and correlation analyses were carried out using Fisher's exact test Results: A total of 60 reports were screened, comprising 56 cases of ductal invasive breast carcinoma and 1 case of lobular invasive breast carcinoma. 48 individuals were tested using the PD-L1 22C3 antibody, with 41.67% of them being positive for PD-L1 expression. Among the 48 tumors tested with 22C3, 35 cases were classified as TNBC, and 13 cases corresponded to luminal B subtype with a low positive expression (1-10%) of estrogen receptors. The percentage of positive PD-L1 cases was 37.14% for TNBC and 53.85% for the luminal B subtype. Furthermore, 5 HER2-low cases were identified with 2 of them being positive for PD-L1 expression. In the correlation analyses, PD-L1 positive expression was significantly associated with a more aggressive histologic grade compared to PD-L1 negative tumors (p = 0.007). No significant association was found between PD-L1 expression and HR, HER2, or KI67 status, nor with age, necrosis, lymphovascular involvement, perineural invasion, desmoplastic response, or immune cell infiltration. Among the 12 individuals tested for PD-L1 with the SP142 antibody, none showed positive expression, precluding correlation analyses. Conclusion: This study highlights a significant association between PD-L1 expression and aggressive histologic grade in Colombian women with breast cancer. The findings underscore the potential of PD-L1 as a prognostic marker and its relevance in guiding immunotherapy in this population. Further research is needed to explore PD-L1 expression in broader Hispanic groups to better understand its clinical implications. Citation Format: Daniel Mendivelso-González, Patricia López- Correa, Nicolás Prada-Aceros, Alfredo E Romero-Rojas, Rafael Parra-Medina. Relationship between PD-L1 expression and clinicopathological characteristics in Hispanic/ Latino women with breast cancer [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C149.

TREATMENT OF PROSTATE CANCER USING ROBOT-ASSISTED LAPAROSCOPIC RADICAL PROSTATECTOMY WITH RECONSTRUCTION OF THE PROXIMAL PROSTATIC URETHRA

Introduction: Prostate cancer (PCa) has been one of the leading oncologic pathologies for decades. In the low-risk group the nerve-sparing technique of surgery is used, which is supplemented by preservation and reconstruction of the prostatic urethra. The effectiveness of this technique in preserving the quality of urination, a significant reduction in the rehabilitation time of patients without reducing the quality of the oncologic result of the operation is described. The aim of the study: To evaluate the long-term results of robot-assisted laparoscopic radical prostatectomy with prostatic urethra reconstruction. Materials and Methods: 60 patients were included in the study. Patients’ selection criteria: low risk of disease prevalence, focal form, tumor location more than 4 mm from the prostatic urethra. During the operation a precision dissection of the prostatic urethra from the prostate is performed. Up to 2cm of the proximal section is preserved, a similar manipulation is performed with the distal urethra. After removal of the prostate, the integrity of the urethra is restored by applying urethro-urethral anastomosis. Before the operation the patients underwent standard examination, including general clinical tests, blood test for prostate-specific antigen (PSA), ultrasound, magnetic resonance imaging (MRI) with 3D modeling. There are also results of pathohistological report, International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF), Quality of Life due to urinary disorders, Partin nomogram. Results: All studied parameters showed good results after 1 month, which were maintained after 6 and 12 months. In 1 patient (1.67%) there was a biochemical recurrence after 6 months (PSA 0.35 ng/ml), which was visualized by MRI as an area of contrast accumulation in the area of neurovascular bundles, the preserved urethra was intact. Conclusion: Based on the results of the study, there is preservation of the quality of life and no increase in oncologic risk one year after surgery. It is possible to expand the selection criteria and perform prostatic urethra preservation without performing nerve-sparing.

Swiss COVID-19 hospital surveillance: an in-depth analysis of the factors associated with hospital readmission dynamics in community-acquired COVID-19 cases.

The COVID-19 pandemic has placed unprecedented pressure on hospitals worldwide. In such a context of tension in healthcare systems, efficiently allocating hospital resources is a crucial aspect of crisis management. The aim of this study was to describe the clinical characteristics of readmitted patients and to determine risk factors for hospital readmission using data from the Swiss COVID-19 Hospital-Based Surveillance system (CH-SUR). We investigated hospital readmissions within 60 days after discharge of patients from the CH-SUR surveillance system with a first hospitalisation between 1 December 2020 and 1 December 2021. Only community-acquired cases were considered. We compared the baseline characteristics of readmitted and non-readmitted patients. We performed univariable and multivariable logistic regression analyses to investigate the risk factors for hospital readmission. Of the 8039 eligible patients, 239 (3.0%, 95% confidence interval [CI] 2.6-3.3%) were readmitted to hospital within 60 days of discharge, with no significant variations observed over the study period; 80% of all readmissions occurred within 10 days of discharge of the index hospital stay. Based on our multivariable logistic regression models, factors increasing the odds of hospital readmission were age ≥65 years (odds ratio [OR] 1.63, 95% CI 1.24-2.15), male sex (OR 1.47, 95% CI 1.12-1.93), being discharged to home after first hospitalisation (OR 1.77, 95% CI 1.19-2.62), having oncological pathology (OR 1.82, 95% CI 1.27-2.61) and being immunosuppressed (OR 2.34, 95% CI 1.67-3.29). Age, sex, cardiovascular diseases, oncological pathologies and immunosuppression were the main risk factors identified for hospital readmission.

Hypermethylation of the BRCA2 gene promoter and its co-hypermethylation with the BRCA1 gene promoter in patients with breast cancer.

The BRCA2 gene is an important tumour suppressor in breast cancer, and alterations in BRCA2 may lead to cancer progression. The aim of the study was to investigate the association of hypermethylation of the BRCA2 gene promoter and its co-hypermethylation with the BRCA1 gene promoter with the development and course of breast cancer in women. This study included 74women with breast cancer (tumour tissue samples and peripheral blood) and 62women without oncological pathology (peripheral blood)- control group. Hypermethylation of the BRCA2 gene was significantly more frequently detected in the tumour tissue of women with breast cancer compared to their peripheral blood and peripheral blood of control subjects (p= 0.0006 and p= 0.00001, respectively). Hypermethylation of BRCA2 was more frequently detected in patients with breast cancer over the age of 50 and in patients with higher Ki67 expression levels (p= 0.045 and p= 0.045, respectively). There was a high frequency of unmethylated BRCA1 and BRCA2 gene combination in women of the control group compared to women with breast cancer, both in blood samples and tumour tissue samples (p= 0.014 and p= 0.00001, respectively). Our study confirms the hypothesis that BRCA2 hypermethylation plays an important role in the pathogenesis of breast cancer and the importance of assessing its co-hypermethylation with BRCA1 in predicting the course of the disease.

Paraneoplastic pembigus: clinical and diagnostic features

Paraneoplastic pemphigus is an autoimmune dermatosis following against the background of neoplasia. It can occur before cancer is diagnosed, during or shortly after treatment, and even during remission of the underlying disease. Typically, paraneoplastic pemphigus only refers to the deposition of IgG. The article is devoted to paraneoplastic IgA/IgG pemphigus, which is one of the rare forms of paraneoplastic pemphigus in which deposition of IgA together with IgG is observed. We have described a clinical case of a patient who developed various rashes during the period of remission of chronic lymphocytic leukemia. Diagnosis of paraneoplastic IgA/IgG pemphigus based on clinical and anamnestic data, the results of a diagnostic skin biopsy, immunofluorescence test, consultation with a hematologist and lab tests. Difficulties in diagnosing paraneoplastic pemphigus are due to the polymorphism of rashes and the variety of clinical and laboratory parameters, which may depend on concomitant oncological pathology. A diagnostic search requires an assessment of the clinical picture of the disease, a carefully collected anamnesis, and a complete diagnostic algorithm for patients with bullous dermatoses.